Collaborating with Providers on Gut Health_Final
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>> Hi there.
Let's chat about a topic that's central to helping clients
with any gut health issue.
How to work as part of a treatment team?
You may have clients who are CGI specialists,
functional medicine doctors, herbalists,
Ayurvedic practitioners, Chinese medicine practitioners,
or any combination of these.
You could visit any of these healthcare providers
to address the same issue and each would approach it
from a somewhat different perspective.
In any case, you can lend your support
as an Integrative Nutrition Health Coach.
Having the basic foundation to navigate
the various modalities, and their languages, philosophies,
and protocols is so important because it helps you
understand your clients and it helps them to feel heard.
You can bridge the gap
between your clients and their healthcare providers,
and you can arm them with knowledge
to expand their treatment options
and advocate for their health.
How great is that?
Using Laura as a case study, let's look at
how it might be best to help Laura navigate
the various practitioners she's seeing.
First, let's begin with Laura visiting a GI specialist.
As the name implies, these are doctors of modern medicine
who specialized in issues of the gastrointestinal tract.
The GI doctor has extensive training
on the anatomy and physiology of the gut.
But her schedule was booked back to back.
So she doesn't have much time to spend with Laura.
The 10 minutes or so she does spend with her,
doesn't allow much time to discuss what's going on.
The doctor asks basic questions,
listens to her symptoms,
and Laura walks away with a diagnosis of GERD.
As they discuss her treatments,
the GI doctors states that she has two goals,
to take away her pain and protect her esophagus.
She prescribes a proton pump inhibitor.
When Laura asks for how long,
the doctor says for as long as she has the symptoms.
On the days that her heartburn is really bad,
she can also take an antacid.
That should do the trick.
Laura isn't given a follow-up appointment.
She's just told to call if things get worse
or if she has any concerns.
The nurse sets her up with an online portal
where she can communicate with the doctor or her staff.
Laura walks away with a diagnosis and a treatment plan.
The root cause is not addressed.
The goal of the GI doctor is to remove symptoms.
This will bring Laura symptom relief
but may not be healing her body in the long-term.
What's missing from this interaction
is time to really get to know Laura,
to learn about what's causing her reflux,
and why this is happening.
She doesn't feel fully heard or understood,
and she hasn't received any information on things she can do
to naturally ease her reflux or avoid triggers.
She's only given a prescription for medication.
As an Integrative Nutrition Health Coach,
how can you step into the picture to fill these gaps?
What can you do from within your scope of practice
to complement the treatment that Laura is receiving
from her GI specialist?
Grab a pen and a piece of paper and pause the video now
to jot down your ideas.
How'd that go?
See, there are many ways that you can work
that complement rather than compete with doctors.
You could help Laura
identifying the root causes for heartburn
by helping her identify and crowd out triggers.
You could help her gain more awareness
into what and how she's eating,
and you can help her manage her stress.
You can help Laura improve her health overall
in a variety of ways that wouldn't come into conflict
with the doctor's treatment plan.
And if you did have a recommendation
that would need her approval,
the online portal would be a great place to connect.
In fact, you can encourage Laura to utilize this tool
to help her communicate with her doctor,
coaching her on what important questions
she may want to ask such as
"What are the risks of the proton pump inhibitor?
Are there any alternatives that might be safer?
Is there a way to evaluate
if my condition is due to low stomach acid?"
A doctor's job is to help treat a condition and its symptoms
so that a larger problem doesn't occur.
This is a valid and important approach.
Your job is to support their treatment plan
and look for ways that you can empower clients to improve
their diet and lifestyle to achieve better health.
And when clients feel like they're not finding
the solution to their health concerns,
you can help them connect with additional resources.
For example, let's say that Laura is wary
of indefinitely using a proton pump inhibitor
and feels like her GI specialist isn't helping her
get to the root cause of what's going on.
You may recommend that Laura visit
a functional medicine doctor.
A functional medicine doctor is an MD
who has gone through functional medicine training.
Functional medicine is systems-based,
meaning that this approach views the body
as a complex hub of integrated systems and parts.
Functional medicine doctors offer alternative
holistic approaches that aim to get
to the root of a problem.
The functional medicine doctor who Laura visits
wants her to temporarily eliminate foods
that commonly trigger heartburn and reflux.
She explains that heartburn can be caused by intolerances
and helps Laura to go on a diet that eliminates gluten,
dairy, and processed foods.
If this doesn't help, she'll have Laura take an IGD test
to identify her food intolerances.
Together they'll go through a trial and error process
to determine the cause of her GERD.
A functional medicine doctor might also suggest
digestive supplements and an HCL supplement.
How can you support Laura now
that she's seeing a functional medicine doctor?
You still have an important role to play.
Can you think of what you would do?
Pause now to jot down your ideas.
What did you come up with?
Here are three ways we came up with
for how you could support Laura in this situation.
You could help her come up with satisfying meal ideas
given the foods available to her on her elimination diet.
You could educate Laura
on how to pick out a quality supplement.
And if they're struggling to figure out the root cause,
you can make suggestions for Laura
to discuss this with her practitioner.
For example,
SIBO is a commonly overlooked cause of heartburn.
You could suggest that Laura ask her doctor
if this might be something worth exploring.
You may also consider working directly in collaboration
with a functional medicine doctor.
Many are willing to work directly with Health Coaches.
See if you can set up an e-mail correspondence,
if both parties approve.
Here's another direction this could take.
Let's say Laura chooses to see an herbalist.
An herbalist uses plants and natural substances
to promote health and healing.
An herbalist will work with Laura
to address her digestion and soothe her reflux.
Something important to keep in mind
is that there is no national certifying or licensing body
for herbalists in United States.
There are many schools
that provide certifications to call oneself an herbalists
but there's no one official certification.
Herbalists have a scope of practice
to follow just like Health Coaches.
So you'll want to make sure that clients like Laura
are still connecting with their primary doctor
to prove any herbs or supplements an herbalist recommends.
An herbalist may work with Western,
Ayurvedic, or Chinese herbs.
It's helpful to inquire if they have a specialty
and where they received their training.
Western herbalists often trained via mentorship.
Chinese herbalists often study herbs
while in acupuncture school.
Ayurvedic herbalists learn their trade
by learning Ayurvedic medicine.
Helping a client clarify their goals
and interests for pursuing an herbalist
can help them find a practitioner who works best for them.
Herbalists aren't necessarily trained
in nutrition or gut health.
They'll look to herbs to promote health
in the way that a Health Coach looks to foods.
And here too, this can involve a bit of trial and error.
Laura's herbalist suggests that she take digestive bitters.
After a week, she decides that the bitters
actually make her acid reflux worse.
This might indicate that Laura actually
does have either high stomach acid
or a weak lower esophageal sphincter muscle.
So instead, the herbalist now recommends cooling herbs
like licorice, meadowsweet, and mallow.
How can you help?
Do you have any ideas?
If so, feel free to pause the video and write them down.
An important way to help overall is to help your client
get clear on what exactly the herbalist is trying to achieve
and the steps you can take to support what they're doing.
For example, is he or she recommending lubricating
and mucilaginous herbs for the purpose of soothing
the GI tract?
Once you know what the objective is,
you can ask how you can complement this objective
through diet.
So for example, maybe you could recommend soothing foods
like oatmeal or pureed vegetable soups.
You can also inquire about if and when
any foods can be used to balance an herbal remedy.
For example, maybe those digestive bitters
are irritating to Laura
because she eats a lot of acidic foods in her diet.
You and the herbalist can work together to troubleshoot.
Let's say Laura decides to see a practitioner
who's trained in Ayurveda.
He or she will look at body type and history to determine
Laura's primary Doshas and where an imbalance is occurring.
Laura is most likely a Vata since she's thin and wiry.
However, her imbalance is in Pitta.
Heartburn is a Pitta imbalance treated as high stomach acid.
An Ayurvedic practitioner will look to balance the Doshas.
Balancing the Pitta Dosha will consist of dietary,
lifestyle, and emotional components.
Part of your job as an Integrative Nutrition Health Coach
will be to support your client through the process
and make sense of how to apply these tools.
For instance, Pittas need to cool off and surrender.
Where can Laura do this in her life?
Pause the video now and take a moment or two to brainstorm.
All right, applying basic principles of Ayurveda,
Laura may be advised to try cooling off
by avoiding spices and spicy foods.
She may also be advised to avoid Vata aggravating foods.
You'll want to make sure she's being supported
with proper nutrition and that she understands
what the recommendations are that are being made and why.
You could help Laura by asking her questions
about her visits with the Ayurvedic practitioner,
the treatment she's getting,
how well she is implementing it,
and how it's making her feel.
Another way to be useful is to play a triage role,
making sure that the Ayurvedic practitioner's treatment
is in line with that of her doctor
and pointing out any discrepancies
where they might be at odds with one another.
Let's visit one more practitioner.
Let's imagine that Laura decides to visit an acupuncturist
who's also a Chinese herbalist.
As part of their training, all licensed acupuncturists
are required to spend at least one year
studying Chinese herbs.
This practitioner will look at Laura's tongue
in addition to taking her pulse.
Many diagnoses in traditional Chinese medicine
rely on readings of the pulse and tongue,
which in addition to revealing symptoms are believed
to help identify the organs causing the imbalance.
Even though heartburn is an issue with digestion
which is ruled by the spleen and stomach
in traditional Chinese medicine,
a Chinese practitioner will look to see
where deficiencies in other various organs
maybe contributing to the problem.
This diagnosis maybe hard to relate to
and can be quite complicated
especially to people who are new to Chinese medicine.
Your job isn't to know the answers,
but you can help Laura to get clear on what it is
she is uncertain about and formulate helpful questions
that she or both of you can bring to the practitioner.
You can also ask how you can complement the work
that the Chinese medicine practitioner's doing
with your client in terms of diet and lifestyle.
It's helpful to pass information back and forth both ways.
The more you begin to understand this modality,
the more you can support clients like Laura
as they navigate alternative types of medicine.
And if you can develop a relationship
with a particular practitioner, over time you can help them
better understand the power of health coaching
and how it can enhance the work that they do.
One thing to keep in mind when discussing
traditional Chinese medicine is that you'll want to stay
within the context of Chinese medicine in terms of language
and concepts as it may be hard to translate
back and forth between in modern approach.
If you don't understand the information you're being given,
don't be afraid to ask questions.
This will only manage your clients the importance
of gathering information in the journey to better health.
Keeping all this in mind,
let's see how this plays out for Laura.
Her Chinese medicine practitioner diagnosis her
with a spleen deficiency and says that Laura
isn't properly transporting and transforming nutrients.
She thinks this might be related to Stagnant Liver "Qi"
which is compromising the spleen.
For this reason, she recommends supporting the liver.
What do you do with this information?
You could check in with Laura to see if she understands
what's going on.
See how she feels about that type of diagnosis
and this type of treatment.
And ask her doctor what foods could support the liver
and help Laura incorporate these into her diet.
The practitioner may or may not understand
the concept of primary food.
But since she suspects the issue is connected to the liver,
she may assume there's an underlying anger issue.
This is something you could explore with Laura.
Does she have pent-up anger in her life?
How could she release any anger she's holding onto?
Whether or not releasing anger in Laura's life improves
her heartburn, overall, it will make her feel better
and work in favor of her health.
No harm in that.
This practitioner may also offer to treat Laura
through acupuncture.
Acupuncture provides relief
but the symptoms often come back.
It's still important to get to the root cause.
You could encourage Laura to ask her practitioner
to teach herself acupressure points that she can do at home.
You could also support her to eat slowly and chew her food,
help her to create a calm environment around meal times,
establish more of a schedule around meals,
and create a safe place for her to talk about her emotions.
In addition to acupuncture,
a Chinese practitioner will often provide
Chinese herbal formulas full of hard to pronounce herbs.
Empower Laura to be an educated consumer,
and encourage her to ask her practitioner to explain
what the herbs are and what they're meant to do.
These herbs typically aren't regulated.
So you want to encourage her to run them
by her primary doctor before trying anything new.
You can help your clients merge eastern and western heeling
into a treatment that works for them
and their individual needs.
Now let's recap.
As an Integrative Nutrition Health Coach,
your role can complement that of other practitioners
by helping clients connect the dots with what's going on
at the root, providing support as they implement
various treatment plans, and providing clients
with what they're not getting elsewhere.
It's important to help clients like Laura
stay aware of her feelings and changes in their body
and to check in regularly to see what's working,
what isn't, and what might be missing.
As you saw in this lecture, there are many types
of practitioners a client may work with.
What it comes down to is helping clients figure out
what will best suit his or her bio-individual needs.
You can support your clients with this
while also figuring out how to add your own value
to the healing process in conjunction with others.
Being territorial of your clients
and viewing other practitioners as competition
will go against your mission to support
and empower your clients to feel their best.
We hope you now have a better idea of the ways that you can
support clients who work with other practitioners.
A good analogy for this comes from sports.
In baseball, a player has a coach for batting,
a coach for pitching, and a coach for base running.
They all work together to help the player
become the best all around player they can be.
What role do you play
as an Integrative Nutrition Health Coach to your clients?
Have you worked with various practitioners?
Let's carry the conversation over to the Facebook group.
Until next time.